A POINT IN THE ADMINISTRATION OF NITROUS OXIDE GAS.

66 has been peculiarly free from cholera during the The explanation appears to be the following. year. NITROUS OXIDE GAS. All outbreaks of cholera can be traced to India and must be introduced, as cholera does not occur spontaneously. The To the Editors of THE LANCET. north road coolie route was closed to coolie traffic on SIRS,-May I ask for a small space in your columns to try Jan. lst, 1899, in order to guard against plague, but it to eliminate during the present century the uncomfortable to have had the additional advantage of keeping and pernicious habit of advising a patient " to breathe appears out cholera. The coolies in former years had to march some " " deeply," to take a deep breath," to breathe as if you were 130 miles to their places of employment along the north road, blowing on a looking-glass," &c., which has been employed and by the time that they arrived they were generally in ever since nitrous oxide insensibility has been induced, and such a depressed condition that they readily succumbed to seems likely to be with us always. Such a method is perany disease to which they were exposed. Now the coolies fectly unnecessary, is very disturbing to the patient, and is have to come straight from the port of embarkation to very much in the way of a comfortable insensibility. I have Colombo and are at once fed and cleansed and then sent to tried to prevent patients from thinking of their breathing for the Ragama camp. On the next day they are sent by train nearly 40 years, but it happens so often that the patient has to their destination. been so instructed that I beg once more to call attention to The plague returns for India show little change. There it as at least undesirable and due to want of thought. were 1b89 deaths for the week ending Dec. 8th, as comI am, Sirs, yours faithfully, pared with 2140 deaths for the previous seven days and TOM BIRD. Brook-street, W., Jan. 1st, 1901. with 1579 for the corresponding week of 1899. The Bombay Presidency reports a decline from 560 to 329 deaths, and the Mysore State also from 610 to 523 deaths. in " THE TREATMENT OF PULMONARY Bengal, however, there has been an increase from 798 to 878 deaths, Gaya and Patna and those districts showing the TUBERCULOSIS." chief development. In Bombay city the returns would make To the Editors of THE LANCET. it appear that the plague is about stationary and the same SiRS,-Having read with much interest, and I trust with may be said for Calcutta. In both cities, however, there profit, Dr. Robert Maguire’s interesting lectures on the above are signs of a recrudescence, more especially in Calcutta subject I am delighted to agree with his incisive criticism in where many more suspicious and plague deaths occur than It is time some counterblast was are reported. For the week there were 65 deaths in Calcutta a great many particulars. raised against the numerous sanatoria springing up like and 70 deaths in Bombay. Your readers will regret to hear that the Corporation of mushrooms all over the country, the main idea being speculation and the well-being or recovery of the inmates quite a Bombay have refused to subscribe towards the Pasteur secondary consideration. In this connexion it would be Institute at Kasauli. The numbers under famine relief have now sunk to interesting to inquire how many cases are accepted for Lord Curzon calculates that the famine treatment who are not genuine cases of tuberculosis but about 250,000. who are perhaps allowed to live in that idea and others has cost the parts of India affected about 750,000 buoyed up into the false hope of cure who are quite beyond lives. As a matter of fact, however, comparatively few died from sheer starvation, although insufficient diet and destihuman aid. No wonder Dr. Maguire makes the remark: "The pro- tution over a considerable period indirectly caused a large, fession seems to have gone mad on this matter." But it is amount of sickness and mortality. One of the most important communications on the subject to be hoped there are some exceptions to this sweeping statement. We all remember the Koch’’ cure " and the numbers of beri-beri appears in the Indian Medical Service paper for of the profession who rushed to Germany to annex the idea December. Captain E. R. Rost, I.M.S., of Burma describesa We know the diplo-bacillus which forms a sort of angle. He has been come home and at once float into fame. result, and the open-air treatment will in a short time die, as working on the idea that beri-beri is a rice disease and has it has done when tried before. The instance of forced found the organism between the starch cells. Several kinds of feeding by mutton chops ad nauseam will probably be’ fermented rice-water are used by the natives and a peculiar improved upon by mechanical aids, something after the yeast which is obtained from Singapore is used to produce manner of feeding turkeys and cramming fowl. The patient them. Captain Rost has also found the same peculiar instanced by Dr. Maguire no doubt paid well for his chops organism in the blood of beri-beri patients in the cerebrobut gave a bad return. It would be nearly as sensible to treat spinal fluid, and in the serous exudation of the sheath of the sciatic nerve. The organism develops spores and is very juvenile " consumptionwith stale bread. active-" wagging one rod in front of the other." In 32 I am, Sirs, yours faithfully, cases of beri-beri the organism was found in every one. It M.R.C.S. Dec. 31st, 1900. seems to be peculiarly resistant to heat.

A POINT IN THE ADMINISTRATION OF

Ceylon

past

_______________

Dec. 13th, 1900. ________________

NOTES FROM INDIA. (FROM OUR OWN CORRESPONDENT.) Plague and the Mecca PilgQ’image.-Tl1e Benefit to Ceylon of Plague Regulations.-The Epidemic at a Standstill.-The Mortality of the Great Famine. The BacÛl1f.s of -

Beri-beri. NOTWITHSTANDING that the

European Governments, including that of Turkey, realise the danger of importing plague the Government of India do not think it necessary to prohibit pilgrimage from the unaffected portions of India during the ensuing season. It is said that the Indian pilgrims during last season were subjected at Turkish ports to many vexatious restrictions and consequent hardships, but the Government of India consider it essential that careful precautions should be observed at Indian ports similar to those which were enforced during the past season. Accordingly, the port of Karachi for pilgrims from parts of the north of India and the port of Chittagong for other parts have been determined as the only places where pilgrims may embark for the Haj. No person will be permitted to make a pilgrimage to Mecca this season from any of the infected portions of India-viz., the Presidency of Bombay excluding Sind, the Madras Presidency, the Mysore State, Coorg, the Jullundur District of the Punjab, and Bengal, excepting the

Chittagong division.

LIVERPOOL. (FROM

OUR OWN

CORRESPONDENT.)

The Lord Mayor’s Hospitals’ Oent1l’I’Y F1.tnd. THE Lord Mayor has issued an appeal to the citizens of Liverpool11 for subscriptions towards a fund which he proposes The Hospitals’ Century Fund," with the object of to call freeing the hospitals from debt. The gross amount of the debit balances of the various hospitals stands at present at about .626,000 ; and the Lord Mayor is anxious that these adverse balances should be discharged during his year of office, thus enabling the hospitals to commence the century free from debt. The Lord Mayor heads the subscription list with the sum of .cZOO. Already E4039 have been promised towards this laudable object. The Lord Mayor’s suggestion is a good one and there is every probability that the requisite amount will be obtained. Lom Death-rate of Liverpool,’ At the weekly meeting of the Health Committee of the City Council held on Dec. 27th, 1900, the chairman congratulated Dr. E. W. Hope, the medical officer of health, upon the low death-rate at present prevailing in the city. The death-rate for the past week was equivalent to 18’6 per 1000, as